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John R. Goldsmith,¹ Charles M. Grossman,^2,3 William E. Morton,^3,4 Rudi H. Nussbaum,^3,5 Ella A. Kordysh,¹ Michael R. Quastel,⁶ Reuven B. Sobel,⁷ and Fred D. Nussbaum^3,8

¹Department of Epidemiology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84120, Israel
²Department of Medicine, Legacy Good Samaritan Hospital, Portland, OR 97210 USA
³Northwest Radiation Health Alliance, Portland, OR 97205 USA
⁴Division of Environmental Medicine, Oregon Health Sciences University, Portland, OR 97201 USA
⁵Department of Physics and Environmental Sciences, Portland State University, Portland, OR 97207 USA
⁶Institute of Nuclear Medicine
⁷Department of Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, 84120, Israel
⁸Computer Consulting, Portland, OR 97225 USA

Abstract

We found an epidemic of juvenile hypothyroidism among a population of self-defined "downwinders" living near the Hanford nuclear facility located in southeast Washington State. The episode followed massive releases of ¹³¹I. Self-reported data on 60 cases of juvenile hypothyroidism (<20 years of age) among a group of 801 Hanford downwinders are presented, as well as data concerning the thyroid status of approximately 160,000 children exposed to radioiodine before 10 years of age as a result of the 26 April 1986 Chernobyl explosion in the former Soviet Union. These children were residents of five regions near Chernobyl. They were examined by standardized screening protocols over a period of 5 years from 1991 to 1996. They are a well-defined group of 10 samples. Fifty-six cases of hypothyroidism were found among boys and 92 among girls. Body burdens of ¹³⁷Cs have been correlated with hypothyroidism prevalence rates. On the other hand, the group of juvenile (<20 years of age) Hanford downwinders is not a representative sample. Most of the 77 cases of juvenile hypothyroidism in the Hanford group were diagnosed from 1945 to 1970. However, the ratio of reported cases to the county population under 20 years of age is roughly correlated with officially estimated mean levels of cumulative thyroid ¹³¹I uptake in these counties, providing evidence that juvenile hypothyroidism was associated with radioiodine exposures. Because even subtle hypothyroidism may be of clinical significance in childhood and can be treated, it may be useful to screen for the condition in populations exposed to radioiodine fallout. Although radiation exposure is associated with hypothyroidism, its excess among fallout-exposed children has not been previously quantified. Key words: Chernobyl, downwinders, exposed children, ¹³¹I contamination, ¹³¹I/¹³⁷Cs body burden, Hanford, hypothyroidism, radiation, radioactive fallout, TSH, thyroid, thyroid-stimulating hormone. Environ Health Perspect 107:303-308 (1999) . [Online 15 March 1999]

http://ehpnet1.niehs.nih.gov/docs/1999/107p303-308goldsmith/ abstract.html

Address correspondence to J.R. Goldsmith, Epidemiology and Health Services Evaluation Unit, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84120, Israel.

A travel grant from the Centers for Disease Control and Prevention supported participation by J.R.G. in the NWRHA Hanford Downwinders Study. Northwest Radiation Health Alliance's distribution and collection of health questionnaires, transfer of responses into a computerized database, and analysis were supported by grants from the McKenzie River Gathering and the Oregon Community Foundations. Part of the Hanford data was presented at the International Conference on the Effects of Low-Dose Radiation, University of Münster, Münster, Germany, 19-21 March 1998.

Received 6 August 1998 ; accepted 4 January 1999.